在美国,私人保险的艾滋病毒感染者中,停用和坚持使用他类药物的性别差异
Thibaut Davy-Mendez1,2, Alan C Kinlaw3,4, Shelby Tungate Lopez5
1Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. tdavy@med.unc.edu.
Journal of general internal medicine
|January 23, 2026
概括
艾滋病毒感染者 (PWH) 经常停止使用他类药物治疗,与男性相比,女性的断药率更高,坚持治疗程度较低. 解决这些障碍对于预防PWH,特别是女性心血管疾病 (CVD) 至关重要.
科学领域:
- 心血管医学 心血管医学
- 传染病流行病学 传染病流行病学
- 药理流行病学 药理流行病学
背景情况:
- 艾滋病毒感染者 (PWH) 面临的心血管疾病 (CVD) 负担高于一般人群,特别是女性.
- 有限的数据存在于PWH中对他类药物的坚持,阻碍了减少心血管疾病差异的努力.
研究的目的:
- 为了检查65岁以下私人保险PWH的他类药物停止和坚持率.
- 为了比较艾滋病毒感染的女性和男性之间对他类药物的坚持.
主要方法:
- 一项使用MarketScan数据从2015-2022年进行的观察性队列研究.
- 对门诊药房索赔的分析,以评估他类药物停用 (间隔>90天) 和覆盖日数 (PDC) 的比例.
- 考克斯模型和日志双项回归被用来比较女性和男性的停药和坚持,并调整了混因素.
主要成果:
- 该研究包括9522名PWH开始使用他类药物治疗;50.0%的患者在2年内停止治疗.
- 总的来说,26.5%的PWH在治疗期间具有较低的他类药物坚持 (PDC <80%).
- 与男性相比,HIV感染女性更有可能停止使用他类药物 (59.0%与48.1%相比),并且在2年内持久度较低 (34.1%与25.2%相比).
结论:
- 在PWH中观察到高水平的他类药物停止和低坚持.
- 与男性相比,艾滋病毒感染女性的停药率显著更高,坚持治疗率更低.
- 有针对性的干预措施是必要的,以克服他类药物坚持障碍,并减轻PWH中心血管疾病风险,重点是女性.
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